OrganizationActive
Canyon Ridge Pain and Spine PC
NPI 1376821587 · Interventional Pain Medicine Physician · Bountiful, UT
Provider details
- NPI number
- 1376821587
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Raul Weston, President(801) 205-4116
- License
- 6955001-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1551 Renaissance Towne Dr
Suite 460
Bountiful, UT 84010-7667
Phone: (801) 205-4116
Fax: (435) 986-9368
Approximate (ZIP-level) locationGet directions
Mailing address
1551 Renaissance Towne Dr
Bountiful, UT 84010-7667
Registry dates
- Enumerated
- 2011-07-22
- Last updated
- 2011-07-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.